More than £273m of this – which equates to the cost of 230 fully staffed medical wards, with 28 beds each - was ‘not related to direct patient care, the RCN said.

Some 11% of the reduction in health spending called for in the 2009 budget could be achieved by cutting expenditure on management consultants, with no impact on patient care, the RCN added.

RCN chief executive and general secretary Dr Peter Carter said: ‘These figures are utterly shocking when you consider the difference that this money could have made to patients. A very significant sum of money is clearly being spent on setting up competition in the NHS and pursuing foundation status, rather than being invested in patient care.’

The figures were obtained from 220 NHS trusts under the Freedom of Information Act.